Senior Insurance Claims Specialist

Job Title: Senior Insurance Claims Specialist

Location: United Arab Emirates (Remote)

Employment Type: Full-Time

Work Arrangement: 100% Remote — Work From Home

Level: Senior

About the Role

We are seeking an experienced Senior Insurance Claims Specialist to manage and oversee insurance claims analysis, documentation review, case coordination, and claims performance monitoring. The role focuses on evaluating policy coverage information, reviewing supporting evidence, assessing claims documentation, identifying inconsistencies, and coordinating the resolution of complex claims across various insurance lines.

The successful candidate will work remotely with underwriting, policy administration, customer service, legal, finance, brokers, and authorized claims professionals to support accurate, timely, and consistent claims handling. The position requires strong analytical skills, sound knowledge of insurance principles, and the ability to manage sensitive customer and financial information.

Key Responsibilities

• Review and assess insurance claims documentation for completeness, consistency, and compliance with applicable policy conditions.
• Analyze policy schedules, endorsements, exclusions, limits, deductibles, and coverage terms relevant to submitted claims.
• Examine supporting evidence, including claim forms, invoices, medical records, repair estimates, incident reports, and other relevant documentation.
• Coordinate the assessment and resolution of complex, high-value, disputed, or escalated insurance claims.
• Identify discrepancies, potential misrepresentation, duplicate submissions, and unusual claims patterns requiring further investigation.
• Review claims assessment reports and recommendations prepared by adjusters, surveyors, medical reviewers, and other specialists.
• Coordinate remotely with loss adjusters, brokers, policyholders, service providers, and internal claims teams.
• Monitor claims progress, outstanding documentation, processing timelines, and service-level performance.
• Support investigations into suspicious or potentially fraudulent claims by organizing evidence and escalating concerns through approved channels.
• Review claims reserves and settlement recommendations for consistency with documented evidence and applicable policy provisions.
• Monitor claims payment records, settlement documentation, and reconciliation exceptions.
• Maintain accurate digital claims files, case notes, correspondence, supporting evidence, and audit trails.
• Support the development and improvement of claims handling procedures, assessment guidelines, and quality control standards.
• Analyze claims trends, loss patterns, settlement ratios, processing delays, and recurring operational issues.
• Prepare management reports covering claims volumes, outstanding liabilities, settlement performance, and emerging risk indicators.
• Assist with internal audits, compliance reviews, regulatory examinations, and claims quality assurance activities.
• Support customer complaint investigations and coordinate appropriate responses with authorized departments.
• Monitor changes in insurance regulations, claims practices, and relevant market developments.
• Recommend process improvements to enhance claims accuracy, operational efficiency, and customer experience.

Qualifications and Experience

• Bachelor's degree in Insurance, Finance, Business Administration, Accounting, Risk Management, or a related discipline.
• Typically 5–8 years of experience in insurance claims management, claims assessment, insurance operations, or loss adjusting coordination.
• Strong understanding of insurance principles, policy coverage, exclusions, deductibles, and claims settlement procedures.
• Experience reviewing claims documentation and coordinating complex or disputed cases.
• Familiarity with one or more insurance lines, such as health, motor, property, casualty, life, or general insurance.
• Knowledge of claims investigation procedures, fraud indicators, and evidence assessment practices.
• Understanding of insurance risk management, claims reserving, and settlement documentation.
• Familiarity with applicable UAE insurance regulations and relevant compliance requirements.
• Experience using insurance claims management platforms, policy administration systems, and digital document management tools.
• Strong analytical and investigative skills, with the ability to interpret policy terms and supporting evidence.
• Excellent written communication, report preparation, and case documentation capabilities.
• Ability to manage competing priorities and maintain accurate records in a remote working environment.
• Strong stakeholder management and coordination skills.
• High standards of confidentiality, professional integrity, and customer service.
• Professional qualifications such as CII, ACII, AIC, or equivalent insurance credentials are advantageous.

What We Offer

• A fully remote, work-from-home position based in the UAE.
• Opportunities to contribute to claims quality, operational improvement, and insurance risk management.
• Collaboration with experienced insurance, legal, underwriting, and finance professionals.
• Exposure to diverse insurance products and complex claims portfolios.
• Professional development and opportunities for career advancement.

How to Apply

Interested candidates should submit an updated CV highlighting their insurance claims experience, policy knowledge, claims assessment capabilities, relevant insurance lines, and professional qualifications.

Application Subject: Application – Senior Insurance Claims Specialist (UAE Remote)

Candidates should confirm applicable employment arrangements, residency requirements, and work authorization before accepting an offer.

• Remote-work scope and authorization: This role involves remote claims documentation review, evidence analysis, case coordination, reporting, and quality oversight. Physical inspections, vehicle or property assessments, medical examinations, in-person investigations, and physical document handling must be performed by qualified local personnel. Clinical determinations must be made by licensed healthcare professionals, while binding coverage decisions, claim approvals, settlement commitments, payment releases, fraud determinations with legal consequences, regulatory notifications, and formal compliance sign-offs must be completed or authorized by appropriately licensed or designated insurance, legal, medical, or compliance professionals.